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Office single puncture laparoscopy sterilization with local anesthesia

G H Miller1

  • 172345.271@compuserve.com

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|January 1, 1997
PubMed
Summary
This summary is machine-generated.

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Office-based laparoscopy sterilization using local anesthesia is safe, with a low major complication rate of 5 in 20,568 cases. This procedure offers a cost-effective alternative for experienced gynecologic laparoscopists.

Area of Science:

  • Gynecologic surgery
  • Minimally invasive procedures

Background:

  • Renewed interest in office-based laparoscopy sterilization under local anesthesia with conscious sedation.
  • Concerns regarding the safety of performing procedures outside a hospital setting.

Purpose of the Study:

  • To determine the incidence of major complications in office-based laparoscopy sterilization.
  • To evaluate the safety of this procedure in an outpatient environment.

Main Methods:

  • Retrospective chart review of 1,190 office-based laparoscopy sterilization cases (1971-1995).
  • Procedures performed under local anesthesia with conscious intravenous analgesia using conventional laparoscopy equipment.
  • Major complications defined as requiring laparotomy, blood transfusion, CPR, or emergency hospital transfer.

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Main Results:

  • One major complication occurred in the author's series, managed in the office.
  • Literature review including the author's cases showed 5 major complications in 20,568 procedures.
  • None of the reported major complications necessitated immediate laparotomy or transfusion to prevent fatality.

Conclusions:

  • Office-based laparoscopy sterilization does not appear to increase the risk of life-threatening complications.
  • The procedure is a viable, cost-effective option for experienced gynecologic laparoscopists.
  • Further consideration of office laparoscopy for sterilization is warranted.